Cervical Insufficiency, also known as Cervical Incompetence is the inability of the uterine cervix to retain a pregnancy in the absence of contractions in the second trimester. With this condition, the cervix begins to dilate and thin before the pregnancy has reached term. Cervical insufficiency can occur in a single pregnancy, or may be recurrent.
It has profound implications for both maternal and neonatal outcomes, including losing a pregnancy, premature delivery and prolonged bed rest during pregnancy.
Cervical Insufficiency can be caused by one or more different factors, including:
- Previous surgery performed on the cervix
- Damage to cervix during a previous difficult child birth
- Birth defect resulting in a malformed cervix or uterus
- Trauma to the cervix from procedure to terminate a miscarriage
- Exposure to DES (Diethylstilbestrol)
If you have had a miscarriage after your second or third trimester, your doctor may check for Cervical Insufficiency. You may also undergo an ultrasound before pregnancy or early on in your pregnancy if you have any potential risk factors for this condition.
Your doctor will examine you through:
- Pelvic exam
The treatment for a Cervical Insufficiency is a procedure to close and reinforce the opening in the cervix. This is performed between 14-16 weeks of the pregnancy, or could be done before the pregnancy. This procedure is called a Cervical Cerclage and is performed primarily through vaginal route. In case of failure of the cerclage or inability to perform through the vaginal route, an abdominal approach is then preferred. This procedure is called a Transabdominal Cerclage, also known as a TAC.
At CEAPS, Dr Moawad’s extensive research on the subject, and his advanced training in performing these procedures, enables patients to have a successful, less morbid minimally invasive procedure with a high success rate.